Face fears with facts

Communication is key ... Cancer for Two author David Bennett and
his wife, Ann.
Photo: Edwina Pickles

Lissa ChristopherAugust 31, 2006

A husband and wife share how they coped with cancer in a
new book.

Chapter eight of David Bennett's new book is titled The Bag
Lady Knocks, but it's not about the arrival of a vagrant. It's
about a visit from the stoma therapy nurse at Cabrini Private
Hospital, who has come to measure his abdomen for a colostomy
bag.

Bennett - a QC and senior fellow of Melbourne University's law
school - underwent routine colonoscopies for 15 years following the
discovery of some benign polyps in his bowel. "All clear" was the
usual finding until about two years ago when a malignant-looking
growth appeared. Cancer For Two tells the story of what
happened next - and it doesn't muck about.

"I think you have colon cancer," is the opening sentence, six
unwelcome words uttered by Bennett's gastroenterologist, Dr Henry
Debinski.

Common sense tells readers Bennett survived to be able to write
the book, but it is nonetheless a suspenseful read. How will his
wife, Ann, react when he goes home to tell her he probably has
cancer? Will he wind up needing the colostomy bag? Will he retain
sexual function after the surgery? Has the cancer already
spread?

The book covers three main areas: medical information about
bowel cancer and the surgery to excise it; how Bennett went about
telling his family, friends and colleagues, and the importance of
their support; and the lifestyle changes he has chosen to adopt
since the surgery.

The medical information is exceptionally clear. "I've read
research that for 80 per cent of cancer patients, their principal
complaint is they don't have enough information," Bennett says.

"What I found really useful was to know the mechanics of the
surgery, to know that if the cancer was in this particular part,
there wouldn't be enough bowel there to rejoin it and if so there
would be one outcome [a colostomy bag]. If there was enough bowel,
there would be another outcome. Those were things that made it
rational. You mightn't like it ... but you knew exactly what you
were dealing with.

"It was also very helpful in talking to other people about it.
You could really explain it and people felt much more
comfortable.

"A friend who is a professor of medicine said he felt the
descriptions of the operation were so clear that doctors should
read it so they could explain clearly to their patients how it's
done."

When he had completed his own story, Bennett asked Ann to write
short additions about her experience of the roller-coaster ride -
hence, Cancer for Two.

"I've got friends who are really very secretive when they've got
a problem like this," she says, "and I don't think it helps them
and I don't think it helps their friends. You never know what to
say. If you don't say anything you feel bad about it - you don't
feel close to them. If you do say something, you feel bad. That's
why I agreed to participate in David's book.

"I was hoping it might help couples who aren't able to
communicate as closely, that it might help them to do that a little
better ... David and I have got a lot of comfort from one another,
being able to operate in an open sort of way."

Bennett also describes lifestyle changes he has made in the hope
of minimising his chances of recurrence. Several of these -
including dietary improvements (less red meat and alcohol, more
fish and vegetables), better stress management and more exercise -
came from Dr Gabriel Kune, emeritus professor of surgery at the
University of Melbourne, who includes this in his list: "Enjoy life
and family and laughter - no scientific data, but it's likely to be
OK and it's fun!"

Bennett says he is doing his best to comply.

Cancer For Two (Michelle Anderson Publishing, $22.95)
is available now.

IMPROVEMENTS IN COLORECTAL SURGERY

Paul McMurrick, Bennett's surgeon, is a colon and rectal
specialist at Cabrini Private Hospital in Melbourne, part of Monash
University's surgery department, where he is a senior lecturer.

McMurrick says there have been at least two significant
improvements in colorectal surgery in recent decades.

The first is the capacity to preserve the pelvic autonomic
nerves, which control sexual and urinary functions in men and
women. Twenty or 30 years ago, the minuscule structures were poorly
understood, he says.

"Quite often they were just sort of chomped through [in the
course of surgery]." Now, "we go to enormous lengths to preserve
those nerves".

The second improvement is a technique called total mesorectal
excision (TME) - broadly, this involves removing intact the entire
package of lymph and blood vessels that support the cancerous
tissue, as well as the tumour itself, so "there's no spillage, as
such, of malignant cells at the time of the surgery".